08-06-2006, 08:07 AM
You are caring for a patient who tells you she commonly uses a variety of "shelf" food supplements, including St. John's wort, although she has no need for these supplements. This woman is taking birth control pills and is on phenobarbitol medication for management of seizures. She has recently experienced mild seizures in spite of the phenobarbitol. St. John's wort is known to contain an antidepressant that induces a microsomal enzyme involved with clearance of a variety of drugs. How should you advise your patient?
Say her epilepsy is getting worse and increase her dose of phenobarbitol.
She should discontinue taking St. John's wort, because it is causing her liver to clear both her anticonvulsant and synthetic estrogens before they can have their beneficial effects.
Triple her dosage of vitamin A to counteract the effects of St. John's wort.
Take three birth control pills each day to prevent pregnancy.
Double her intake of St. John's wort to avoid de
Say her epilepsy is getting worse and increase her dose of phenobarbitol.
She should discontinue taking St. John's wort, because it is causing her liver to clear both her anticonvulsant and synthetic estrogens before they can have their beneficial effects.
Triple her dosage of vitamin A to counteract the effects of St. John's wort.
Take three birth control pills each day to prevent pregnancy.
Double her intake of St. John's wort to avoid de